Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | A143858 | CA |
N | 2080P0208X | Pediatric Infectious Diseases | MT199050 | PA |
NPI | 1164773909 |
---|---|
Provider Name | Beatriz Larru |
First Address | Los Angeles, CA 90010-2804 |
Second Address | Los Angeles, CA 90010-2814 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2012 |
Last Update Date | 01/09/2016 |